Canadian permanent residence applicants will face a major change in Express Entry medical exam requirements starting August 21, 2025. New applicants must complete an Immigration Medical Exam (IME) before they submit their Express Entry application.

This big change in policy affects many clients who want to immigrate to Canada. Medical exams for PR have become a must-do step before application instead of after. Immigration, Refugees and Citizenship Canada (IRCC) requires these medical exams to protect public health and safety. The exams help identify medical conditions that might put extra strain on healthcare services and ensure applicants meet health standards. Medical exam results stay valid for 12 months from the exam date. It’s worth mentioning that this new rule won’t affect applications submitted before August 21. The rules also require all immediate family members to complete the medical exam upfront, even if they’re not coming to Canada with the applicant. This represents a big change in process that needs careful planning for Express Entry candidates.

IRCC mandates upfront medical exam for Express Entry applicants

Immigration, Refugees and Citizenship Canada (IRCC) has announced a most important policy change. All Express Entry applicants must complete their medical examination before submitting their permanent residence application.

Policy effective from August 21, 2025

The upfront medical exam rule will start on August 21, 2025. This creates a key deadline for people who want to apply. The policy affects only Express Entry streams. Applications through other permanent residence programs will follow the current process. IRCC has confirmed that applications submitted before this date won’t need to follow these new rules. Candidates preparing their Express Entry applications now have a clear timeline to apply under existing rules.

How this changes the previous process

This policy changes the approach that started on October 1, 2023. The old system let applicants submit their permanent residence applications first and complete medical exams later after IRCC’s instructions. Candidates would create their Express Entry profile, get an Invitation to Apply (ITA), submit their application, and wait for IRCC’s request for medical examination. The new requirement changes this order completely. Applicants must now visit an IRCC-approved panel physician, finish their medical examination, and get proper documentation before submitting their Express Entry application.

Why the change was introduced by IRCC

IRCC’s decision to bring back the upfront medical examination requirement aims to improve processing speed and cut delays. Medical results available during application processing help IRCC review complete applications right away. This change may help the department meet its six-month service standard for Express Entry applications. The upfront requirement makes applications “decision-ready” from a medical point of view and removes waiting times that were needed for medical examination instructions and results. The change adds an extra step at the start but makes the rest of the process faster by removing a common delay in application processing.

IRCC outlines who must complete the medical exam

The upfront medical exam requirement targets specific immigration candidates who want permanent residency through the Express Entry system. IRCC has released detailed guidelines about who needs these medical examinations to meet Canadian health admissibility standards.

All principal applicants and family members included

The express entry medical exam is now mandatory for all principal applicants seeking permanent residence. This requirement applies to all family members, whatever their plans to move to Canada. Every person who might enter Canada must meet the health requirements. The IRCC medical exam checks if applicants or their family members have health conditions that could risk public health or put too much strain on Canadian healthcare services. The excessive demand cost threshold for 2025 stands at CAD 37,846.45 per year or CAD 189,232.25 over five years. Applications might face rejection if costs exceed these limits.

Exemptions for in-Canada applicants with recent IMEs

IRCC offers exemptions to candidates who already live in Canada. The government has a temporary public policy that lets certain foreign nationals skip repeat medical examinations until October 5, 2029. Applicants must meet all but one of these conditions to qualify: they must live in Canada, have finished a previous Immigration Medical Examination (IME) within the last five years, and their previous exam must show low or no risk to public health or safety. Qualified applicants can use their previous IME number or unique medical identifier in their PR application instead of taking a new exam.

Clarification on accompanying vs. non-accompanying dependents

Many applicants miss a crucial detail about non-accompanying dependents. IRCC requires all dependents to complete the upfront medical exam for PR, even if they won’t join the principal applicant in Canada. The principal applicant’s application might fail if any dependent fails the medical requirements. The rules also state that all dependents must be medically admissible for future sponsorship eligibility. A successful Express Entry application needs all family members to complete their medical exams, whatever their current immigration plans.

Applicants must follow specific steps to complete the upfront medical exam

The Express Entry medical exam needs several significant steps that you must follow carefully. Many of our clients ask about this process, so here’s a detailed guide to help you through it.

How to find an IRCC-approved panel physician

A panel physician approved by IRCC must conduct your upfront medical exam for PR. Your family doctor can’t do this examination, whatever their qualifications or your relationship with them. The official IRCC panel physician directory online helps you find authorized doctors. These approved physicians use IRCC’s eMedical system to send your results directly to immigration authorities. The sort of thing I love about this process is that you can pick a panel physician anywhere in the world, even if you live somewhere else.

What to bring to your medical exam appointment

Everything in your appointment preparation needs careful attention. You should bring valid ID (your passport works best), medical reports for any existing conditions, a list of your current medications, and vaccination records if you have them. On top of that, it might need four recent photographs if your physician doesn’t use the eMedical system. The exam costs vary between CAD 195.07 and CAD 390.14 per person.

What happens during the medical exam for PR

The physician checks your identity at the time of your appointment and takes your photo for IRCC records. Your exam has sections for medical history review, physical examination, chest x-rays if needed, blood and urine tests, mental health evaluation, and vaccination record verification. The physician then sends your results to IRCC through their secure system.

How to submit IMM 1017B or printout to IRCC

The panel physician gives you either an Information printout sheet or an IMM 1017B Upfront Medical Report form after your exam. You’ll need to upload one of these documents to your permanent residence application through the Express Entry Profile Builder to prove you completed the medical examination.

IRCC provides guidance on using previous IME results

IRCC gives Express Entry candidates some flexibility with their Immigration Medical Examination (IME) results. This saves both time and money if you’ve already completed the process.

Conditions under which old IMEs can be reused

You can reuse your previous medical exam results if you meet these requirements: you must live in Canada right now, you should have completed an IME in the last five years, and your previous exam should show that you’re not a risk to public health and safety. The government has confirmed this policy will stay in place until at least October 5, 2029. This exemption helps temporary residents who want to become permanent residents and have managed to keep good health standing. If you meet these criteria, you won’t need an upfront medical exam for PR – a requirement that applies to all but one of these Express Entry candidates after August 21, 2025.

What to do if IRCC rejects previous IME results

You might think you qualify for an exemption, but IRCC makes the final call on whether your previous results are still good enough. Different visa types need different medical checks, so IRCC might decide your previous exam doesn’t work. If this happens, IRCC will send you written instructions about getting a new medical examination. Express Entry applications have a 60-day deadline after ITA, so you should be ready to book an appointment with a panel physician quickly if your previous results don’t work out.

How to upload IME number or documents in Express Entry profile

You’ll need to provide one of these three things to reuse previous results: the Information printout sheet, the IMM 1017B Upfront Medical Report form, or your IME number (your unique medical identifier). Upload these documents as PDFs through the Express Entry Profile Builder when you submit your permanent residence application. Getting this information ready beforehand makes the whole process smoother if you have previous IMEs. Your application might face delays or even be refused if you don’t include these documents.

Steps From Here

Canada’s Express Entry medical examination policy will see a fundamental change in the permanent residence application process. Starting August 21, 2025, applicants must complete their Immigration Medical Exam before they submit their application. This change creates extra steps for people who want to immigrate but makes the process faster by making applications “decision-ready” in IRCC’s queue.

Our clients should pay close attention to these dates, especially if they’re getting their Express Entry applications ready now and want to avoid the medical requirement upfront. The new rules apply to all family members – even those who don’t plan to come to Canada right away. Family members’ medical inadmissibility could affect the main applicant’s permanent residence status.

The new process might seem like an extra step at first, but it speeds up later stages by removing the wait time for medical exam instructions. Some people already living in Canada might not need new exams if they’ve had an IME in the last five years that showed minimal health risks. IRCC’s approach shows its steadfast dedication to both thoroughness and practicality.

Applicants need to find an IRCC-approved doctor, go to their appointment with the right papers, and get an Information printout sheet or IMM 1017B form for their application. Medical exam costs run between CAD 195.07 and CAD 390.14 per person – a needed investment in your immigration trip. People seeking exemptions should be ready to schedule new exams quickly if IRCC doesn’t accept their previous results, given Express Entry’s time constraints.

This policy change shows Canada’s commitment to a strong yet efficient immigration system. Express Entry candidates should plan ahead, knowing that this extra step at the start could make the whole process faster. Medical exam results stay valid for 12 months, giving applicants enough time to work through the Express Entry system. As your legal team, we’ll help you navigate these changes and make sure your permanent residence application meets all requirements under these new medical exam rules.

Key Takeaways

Starting August 21, 2025, Canada’s Express Entry system requires all applicants to complete medical exams before submitting their permanent residence applications, reversing the previous post-application process.

• Complete medical exams upfront: All Express Entry applicants and family members must undergo Immigration Medical Exams before application submission, costing CAD 195-390 per person.

• Use IRCC-approved physicians only: Medical exams must be conducted by authorized panel physicians who can transmit results directly through IRCC’s eMedical system.

• In-Canada residents may qualify for exemptions: Current Canadian residents with IMEs completed within five years showing low health risks can reuse previous results until October 2029.

• All dependents must be examined: Even non-accompanying family members require medical clearance, as inadmissible dependents can render the principal applicant inadmissible.

• Applications submitted before August 21, 2025 are exempt: Current applicants can avoid this requirement by submitting before the implementation date.

This policy change aims to streamline processing by ensuring applications are “decision-ready” from a medical perspective, potentially reducing overall processing times while maintaining Canada’s health admissibility standards.

FAQs

Q1. Is an upfront medical exam now required for Express Entry applications? Yes, starting August 21, 2025, all Express Entry applicants must complete an Immigration Medical Exam (IME) before submitting their permanent residence application. This applies to principal applicants and all family members, even those not immediately immigrating to Canada.

Q2. How long is the medical exam valid for Express Entry applications? Typically, an Immigration Medical Exam (IME) for Express Entry remains valid for 12 months from the date of examination. It’s important to time your medical exam appropriately to ensure it remains valid throughout the application process.

Q3. Can I use results from a previous medical exam for my Express Entry application? You may be able to reuse previous IME results if you currently reside in Canada, completed an IME within the past five years, and your previous examination indicated low or no risk to public health and safety. This exemption policy is valid until October 5, 2029.

Q4. How much does the medical exam for Express Entry cost? The cost of the Immigration Medical Exam for Express Entry generally ranges from CAD 195.07 to CAD 390.14 per person. This fee is paid directly to the panel physician conducting the examination.

Q5. What happens during the medical exam for permanent residence? The medical exam typically includes a review of your medical history, a full-body physical examination, potential chest x-rays, blood and urine tests, a mental health assessment, and an immunization record check. The approved panel physician will then send your results directly to Immigration, Refugees and Citizenship Canada (IRCC) through their secure system.